News: Ischemic heart disease death rates decrease, rise in other heart disease deaths, study finds

A study published by the Journal of the American Heart Association found that ischemic heart disease death rates fell 81% from 1970 to 2022 while deaths from heart attacks decreased 89% in that time span. These declines were attributed to advancements in intervention and prevention efforts.

However, deaths from other types of heart disease increased by 81% during the same period. The study said the rising prevalence of obesity, diabetes, hypertension, and physical inactivity have contributed to those causes.

Mortality data was accessed for all United States adults aged 25 years and older from 1970 through 2022 from the National Vital Statistics System. Data extraction focused on death certificates with the following conditions and ICD-10-CM code categories:

• Ischemic heart disease
  
  • Angina pectoris (I20.-)
  • Acute myocardial infarction (I21.-)
  • Subsequent ST elevation and non-ST elevation myocardial infarction (I22.-)
  • Other acute ischemic heart diseases (I24.-)
  • Chronic ischemic heart disease (I25.-)
• Other heart disease subtypes
  
  • Acute rheumatic fever and chronic rheumatic heart disease (I00-I09)
  • Hypertensive heart disease (I11.-, I13.-)
  • Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)
  • Valvular heart disease (nonrheumatic) (I34-I38)
  • Cardiomyopathy (I42.-)
  • Cardiac arrest and ventricular arrhythmias (I46.2, I46.8, I46.9, I49.0.-)
  • Arrhythmia (I47-I49, excluding I49.0-)
  • Heart failure (I50.-)
  • Other cardiac conditions
    • Diseases of pericardium and acute and subacute endocarditis (I30‐I33)
    • Acute myocarditis (I40.-)
    • Atrioventricular and left bundle-branch block and other conduction disorders (I44-I45)
    • Complications and ill-defined descriptions of heart disease (I51.-)

Equivalent ICD‐8 and ICD‐9 codes for ischemic heart disease were included as well, although this could have allowed for potential miscoding and challenges in maintaining consistency in comparisons across the years.

This limitation may suggest that the true burden of ischemic heart disease is underestimated in the study’s findings. Out of the other heart disease subtypes, heart failure, hypertensive heart disease, and arrhythmia had the largest increases (12%, 13%, and 4%, respectively) of the total heart disease mortality in 2022.

It was also discovered that from 1970 to 2022, the distribution of deaths within heart disease shifted. In 1970, ischemic heart disease comprised 91% of all heart disease deaths, but only 53% in 2022, whereas other heart disease subtypes have increased from 9% of all heart disease deaths in 1970 to 47% in 2022.

The decline in ischemic heart disease mortality represents a pivotal achievement, but the rise in heart disease mortality from other conditions, such as heart failure, hypertensive heart disease, and arrhythmias, must be addressed. The study encourages future research to focus on managing the growing challenge of these heart conditions, while continuing to maintain and expand the progress in ischemic heart disease.

Editor’s note: This article was originally published in JustCoding. To read the full study, click here.